It might be strange to think of sleeping as a skill that does not come naturally. As a new parent, you’re probably so exhausted that you pass out as soon as your head hits the pillow. Your baby, however, doesn’t have this same ability yet. Although they spend a lot of time sleeping, they need to learn when to sleep (day vs. night) and how to sleep. Until they do, they need your assistance, which is why you (as you should) help soothe them to sleep at bedtime and comfort them when they wake in the middle of the night. Sleep training is teaching your baby how to sleep without any help from you - just like you’re able to fall asleep without anyone there to help you do it.
In clinic, I help parents with their children’s sleep problems. But in my own home, I found it challenging to apply the techniques I recommended to others. What seems obvious in a brightly-lit exam room is harder to follow at 2 a.m. Like many pediatricians do with their own children, I elected to try extinction sleep training, which involves letting a child cry in order to learn to soothe himself to sleep on his own. Night one was relatively easy, but night two left my wife in tears and me feeling like a heel. Things improved on night three, and our son scarcely cried on night four. By the end of the week, he was sleeping through the night again.
The most well known cry it out technique is the one developed by pediatrician Richard Ferber, director of the Center for Pediatric Sleep Disorders at Children's Hospital Boston. Ferber says that in order to fall asleep on their own and sleep through the night, babies have to learn to soothe themselves. Ferber believes that teaching a baby to soothe himself may involve leaving him alone to cry for prescribed periods of time.
Adapt the method to fit your family. If you want to try a method like this but find it too harsh, you can use a more gradual approach. For instance, you can stretch out Ferber's seven-day program over 14 days, increasing the wait every other night rather than every night. Remember your primary objective: To give yourself and your child a good night's rest.
Pantley offers a gentle and gradual approach to all aspects of sleep, customized to your baby's needs. She recommends rocking and feeding your baby to the point of drowsiness before putting him down – and responding immediately if he cries. Parents are urged to keep sleep logs, nap logs, and night-waking logs. Pantley also describes a six-phase process for teaching a child to sleep in a crib.
Hogg agrees with Sears that sleep associations should be positive but disagrees with his techniques. She cautions against letting your baby depend on "props" such as nursing, patting, and rocking to get to sleep. Instead, Hogg's approach calls for going to your baby when he cries, picking him up, and putting him back down as many times as necessary.
There’s an awful lot of information on how to sleep train out there, leaving most parents confused, frustrated, and still wondering what sleep training is and how to do it. In this article, we’ve rounded up all the facts from real moms and professional sleep consultants on what sleep training is, how to do it, and how to decide if it’s right for you.
While you may have read up on various sleep training methods while pregnant or in the early weeks of baby’s life, it’s a good idea to speak with your pediatrician before you start. For example, if your child is gaining weight slowly or was a preemie, he may not be ready to drop a nighttime feeding and may need a sleep-training schedule that’s adapted to a few middle-of-the-night wake-ups.
With the fading technique, continue with whatever method you were using to help your baby fall asleep (such as rocking or nursing), but decrease the amount of time you spend doing it until, in theory, you don’t have to do it at all. This is a great technique for minimizing crying, but unfortunately, many parents find it difficult to sustain. “There has to be an end in sight,” explains Mitelman. “For example, we’ll meet this need for five to seven days and then we’ll pull back a little bit.” But if you’re willing to stick to the plan and get your baby to the end goal of going to bed without your assistance, Mitelman says it’s worth a try. “Whichever way the child can get to sleep independently is fine because that’s the key ingredient to sleeping through the night.”
A version of this technique called graduated extinction was popularized by Dr. Richard Ferber in his book “Solve Your Child’s Sleep Problems.” Here, parents check on their child at set intervals. Checks should be brief and to the point: Picking up your child, spending too much time hovering over the crib or otherwise offering more contact than a quick soothing word can be counterproductive. Some babies find these brief checks soothing and will go to sleep more quickly. Others will redouble their crying as soon as their parents leave the room. Parents need to make a judgement about whether or not checking in is helping their baby through this process. If you decide to use checks, I would recommend checking no more than every five minutes and resisting the temptation to check if your child seems to be calming down.
As you might suspect, this method can be very difficult, depending on temperament, and can take many days or weeks. It can be difficult to avoid engaging with your child (and “watching them cry” is very difficult), and it will likely be a little confusing to the child (particularly younger ones) when you don’t. However, with time and consistency, this can be a good option for parents who do not want to leave their child alone to cry but who haven’t had success with other methods, either.
• Chair method. Also called the sleep lady shuffle or gradual withdrawal and popularized by Kim West, LCSW-C, author of Good Night, Sleep Tight, this method starts with you sitting in a chair next to baby’s crib. Each night, you move the chair farther away from the crib, verbally soothing or shushing baby when she cries (although occasional patting and picking up are okay) until you’re no longer in the room. This method can be helpful for older babies and toddlers who may suffer from separation anxiety and can understand that Mom and Dad are just on the other side of the door, but it also works for younger babies.
The age of your baby might determine what kind of sleep-training method you choose, though. You could try a gentle shush-pat technique with a five-month-old, but you’ll likely have to leave a one-year-old in the crib as they protest (cry or scream) about the new bedtime arrangement. Don’t attempt a formal sleep-training method before four months, until your baby is able to go longer in between feeds and their circadian rhythm starts to develop. (Many babies this age still feed in the night—contrary to popular thinking, sleep training isn’t synonymous with night weaning.) Dickinson says that many four-month-old babies are biologically able to go through the night without a feed, but that doesn’t mean you shouldn’t respond and feed them if other methods of calming them aren’t working. Since every situation is different, we recommend checking with your doctor before withholding your baby’s night-time feeds.